Background: Organ shortage is a massive global issue, and the high costs of living organ donation only exacerbate the problem. In order to encourage citizens to donate, some countries have implemented policies to remove disincentives to donation and to provide incentives to living organ donors. Our goal is to analyze the efficacy of such policies.

Methods: Nine countries (Australia, Iran, Ireland, Israel, New Zealand, Saudi Arabia, Singapore, the United Kingdom, and the United States) with explicit reimbursement policies were selected for policy analysis. Six of these countries (Iran, Israel, Saudi Arabia, Singapore, the United Kingdom, and the United States) were selected for statistical analysis based on 1) the completeness of their organ donation data and 2) the length of time that their policies have been in effect. For these six countries, linear regression was performed on the number of living organ donors per million of population (PMP) before policy implementation to predict the number of living organ donors PMP after policy implementation. Paired t-tests were then used to compare the predicted numbers of living organ donors PMP per year to the actual numbers of living organ donors PMP per year after policy implementation.

Results: All nations' policies were found to reimburse living donors for at least travel costs directly related to the donation. The United States' policy was the only one to not reimburse lost income. In addition to providing these reimbursements, three nations (Israel, Saudi Arabia, and Iran) provided donors with direct incentives. The policies of Saudi Arabia, the United Kingdom, and Israel had a significant effect (p<0.05) in increasing the number of living organ donors, while the United States' policy had a significant effect in decreasing the number of living organ donors. Singapore and Iran did not experience a significant change in the number of living donors. However, Singapore's numbers have been increasing in recent years, and Iran's numbers increased soon after policy implementation.

Conclusions: While other factors, such as religion and income, may affect the number of living donors, the data generally suggest that policies that financially assist living donation are effective in increasing the number of living donors in varying degrees, with a rough correlation between how much donors are helped and the degree of increase. The efficacy of these policies suggests that other countries may benefit from considering similar policies for easing their organ shortage problem.

CITATION INFORMATION: Apte V, Fry-Revere S. Efficacy of Nine National Policies Reimbursing and Incentivizing Live Organ Donation. Am J Transplant. 2016;16 (suppl 3).

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